Study on interactive journey map of perioperative medical experience of patients undergoing pulmonary nodule day surgery under enhanced recovery after surgery mode_West China Medical Journal

Authors：

WU Mei ¹ ,  XIA Lu ¹ , ZHANG Li ¹ , GU Fen ² , SHEN Xiaoyong ³ , CHEN Long ⁴

1. Day Surgery Ward, Huadong Hospital, Fudan University, Shanghai 200040, P. R. China;
2. Department of Nursing, Huadong Hospital, Fudan University, Shanghai 200040, P. R. China;
3. Department of Thoracic Surgery, Huadong Hospital, Fudan University, Shanghai 200040, P. R. China;
4. Medical Affair Department, Huadong Hospital, Fudan University, Shanghai 200040, P. R. China;

Corresponding author：

XIA Lu, Email: yihaibeilu@hotmail.com

Keywords：

Patient journey map; pulmonary nodule; day surgery; patient experience; enhanced recovery after surgery

DOI：

10.7507/1002-0179.202411203

Video：

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Objective To identify the needs of patients undergoing pulmonary nodule day surgery during the perioperative medical interaction experience under the enhanced recovery after surgery mode based on the patient journey map, and to provide references for optimizing the diagnosis and treatment experience of these patients and the patient-centered medical support. Methods Using the descriptive qualitative research method, 15 patients who underwent thoracoscopic pulmonary nodule resection or pulmonary wedge resection in the day surgery ward of Huadong Hospital, Fudan University between January and June 2024 were selected for semi-structured interviews. The data were analyzed using the content analysis method, and the interactive map of the patient’s medical seeking experience was drawn. Results According to the medical seeking process and perioperative stages, the interactive journey map of the patient’s medical seeking experience was formed. The medical seeking experience and health support needs of patients undergoing pulmonary nodule day surgery were classified and summarized into themes such as medical consultation cues, screening of medical information, multidisciplinary assessment, medical-patient cognitive differences, rehabilitation exercises and sports, nutritional management, doctor-patient communication, social adaptation, and emotional expression from four links: interaction touchpoints, information flow, communication methods, and feedback mechanisms. Conclusions Patients undergoing pulmonary nodule day surgery experience the perioperative medical seeking process under the enhanced recovery after surgery mode, with a shortened hospitalization period but complex postoperative health management needs. The interaction touchpoints generated during the experience are intertwined and changeable, and the health support needs required vary at different stages of intervention points. Optimizing the touchpoints can ensure that patients receive efficient medical support when needed, thereby enhancing the patient experience, improving the medical seeking feeling, and ensuring that high-quality nursing services are implemented throughout all stages.

Citation： WU Mei, XIA Lu, ZHANG Li, GU Fen, SHEN Xiaoyong, CHEN Long. Study on interactive journey map of perioperative medical experience of patients undergoing pulmonary nodule day surgery under enhanced recovery after surgery mode. West China Medical Journal, 2025, 40(2): 276-281. doi: 10.7507/1002-0179.202411203 Copy

1.	马天文, 谢晨, 曹劲松, 等. 低剂量 CT 在肺结节筛查中的应用及预测模型的建立. 中国 CT 和 MRI 杂志, 2024, 22(9): 53-56.
2.	梁文华, 黎才琛, 何建行. 肺癌早筛早诊的精准化探索. 中国肿瘤临床, 2021, 48(10): 506-510.
3.	吕亚军, 黄艳红, 张久荣. 合并症负担对早期非小细胞肺癌患者胸腔镜肺叶切除术后并发症的影响:一项倾向性评分匹配分析. 中国全科医学, 2020, 23(20): 2498-2502, 2519.
4.	车国卫. 加速康复外科: 肺癌手术日间化现状与策略. 中国肺癌杂志, 2020, 23(1): 1-4.
5.	俞德梁, 宁鹏涛, 王娟, 等. 关于日间手术定义与首批推荐适宜手术的思考. 医学与哲学, 2015, 36(24): 5-7, 14.
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7.	中国人民共和国国家卫生健康委员会. 国家卫健委印发《关于开展改善就医感受提升患者体验主题活动的通知》. 食品与健康, 2023, 35(8): 4.
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9.	戴梦峤, 廖晓琴. 患者旅程地图在慢性病照护中的研究进展. 护理学杂志, 2024, 39(13): 121-125.
10.	Mrklas KJ, Barber T, Campbell-Scherer D, et al. Co-design in the development of a mobile health app for the management of knee osteoarthritis by patients and physicians: qualitative study. JMIR Mhealth Uhealth, 2020, 8(7): e17893.
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12.	Bharatan T, Devi R, Huang PH, et al. A methodology for mapping the patient journey for noncommunicable diseases in low- and middle-income countries. J Healthc Leadersh, 2021, 13: 35-46.
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14.	Ly S, Runacres F, Poon P. Journey mapping as a novel approach to healthcare: a qualitative mixed methods study in palliative care. BMC Health Serv Res, 2021, 21(1): 915.
15.	Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs, 2008, 62(1): 107-115.
16.	史校铭, 焦子宸, 张子睿, 等. 集中管理日间手术模式下胸腔镜手术与普通住院手术模式治疗肺结节的疗效及安全性比较. 川北医学院学报, 2023, 38(6): 806-809.
17.	张黎, 刘洋, 黄明君, 等. 胸腔镜肺结节日间手术患者精细化管理效果研究. 华西医学, 2021, 36(2): 183-189.
18.	Van Schalkwijk DL, Widdershoven JWMG, Elias-Smale S, et al. ShareHeart: a patient journey map of patients with ischemia and non-obstructive coronary artery disease based on qualitative research. J Clin Nurs, 2023, 32(13/14): 3434-3444.
19.	Saragosa M, Nizzer S, McKay S, et al. The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping. BMC Health Serv Res, 2023, 23(1): 934.
20.	Farmer J, Bigby C, Davis H, et al. The state of health services partnering with consumers: evidence from an online survey of Australian health services. BMC Health Serv Res, 2018, 18(1): 628.
21.	张育琳, 金晓凤, 黄文婷, 等. 改善患者就医体验提升满意度实践探索. 中国医院, 2024, 28(6): 88-90.
22.	张霄艳, 王静, 王雨璇. 武汉市基层医疗机构就诊患者的感知服务质量和满意度对忠诚度的影响机制分析. 医学与社会, 2023, 36(6): 59-63, 99.
23.	张蕊, 赵丽亭, 吴美, 等. 加速康复外科多学科团队协作模式在日间手术中应用的范围综述(英文). 中西医结合护理(中英文), 2023, 9(7): 180-185.
24.	王淼, 杨丽, 黄一敏, 等. 上海市级医院儿童日间手术进展与思考. 中国卫生质量管理, 2021, 28(3): 1-2, 8.

1. 马天文, 谢晨, 曹劲松, 等. 低剂量 CT 在肺结节筛查中的应用及预测模型的建立. 中国 CT 和 MRI 杂志, 2024, 22(9): 53-56.
2. 梁文华, 黎才琛, 何建行. 肺癌早筛早诊的精准化探索. 中国肿瘤临床, 2021, 48(10): 506-510.
3. 吕亚军, 黄艳红, 张久荣. 合并症负担对早期非小细胞肺癌患者胸腔镜肺叶切除术后并发症的影响:一项倾向性评分匹配分析. 中国全科医学, 2020, 23(20): 2498-2502, 2519.
4. 车国卫. 加速康复外科: 肺癌手术日间化现状与策略. 中国肺癌杂志, 2020, 23(1): 1-4.
5. 俞德梁, 宁鹏涛, 王娟, 等. 关于日间手术定义与首批推荐适宜手术的思考. 医学与哲学, 2015, 36(24): 5-7, 14.
6. 马正良, 黄宇光, 顾小萍, 等. 成人日间手术加速康复外科麻醉管理专家共识. 协和医学杂志, 2019, 10(6): 562-569.
7. 中国人民共和国国家卫生健康委员会. 国家卫健委印发《关于开展改善就医感受提升患者体验主题活动的通知》. 食品与健康, 2023, 35(8): 4.
8. Davies EL, Bulto LN, Walsh A, et al. Reporting and conducting patient journey mapping research in healthcare: a scoping review. J Adv Nurs, 2023, 79(1): 83-100.
9. 戴梦峤, 廖晓琴. 患者旅程地图在慢性病照护中的研究进展. 护理学杂志, 2024, 39(13): 121-125.
10. Mrklas KJ, Barber T, Campbell-Scherer D, et al. Co-design in the development of a mobile health app for the management of knee osteoarthritis by patients and physicians: qualitative study. JMIR Mhealth Uhealth, 2020, 8(7): e17893.
11. 中华医学会呼吸病学分会, 中国肺癌防治联盟专家组. 肺结节诊治中国专家共识(2024 年版). 中华结核和呼吸杂志, 2024, 47(8): 716-729.
12. Bharatan T, Devi R, Huang PH, et al. A methodology for mapping the patient journey for noncommunicable diseases in low- and middle-income countries. J Healthc Leadersh, 2021, 13: 35-46.
13. Harris KW, Hammack-Aviran CM, Brelsford KM, et al. Mapping parents’ journey following prenatal diagnosis of CHD: a qualitative study. Cardiol Young, 2023, 33(8): 1387-1395.
14. Ly S, Runacres F, Poon P. Journey mapping as a novel approach to healthcare: a qualitative mixed methods study in palliative care. BMC Health Serv Res, 2021, 21(1): 915.
15. Elo S, Kyngäs H. The qualitative content analysis process. J Adv Nurs, 2008, 62(1): 107-115.
16. 史校铭, 焦子宸, 张子睿, 等. 集中管理日间手术模式下胸腔镜手术与普通住院手术模式治疗肺结节的疗效及安全性比较. 川北医学院学报, 2023, 38(6): 806-809.
17. 张黎, 刘洋, 黄明君, 等. 胸腔镜肺结节日间手术患者精细化管理效果研究. 华西医学, 2021, 36(2): 183-189.
18. Van Schalkwijk DL, Widdershoven JWMG, Elias-Smale S, et al. ShareHeart: a patient journey map of patients with ischemia and non-obstructive coronary artery disease based on qualitative research. J Clin Nurs, 2023, 32(13/14): 3434-3444.
19. Saragosa M, Nizzer S, McKay S, et al. The hospital-to-home care transition experience of home care clients: an exploratory study using patient journey mapping. BMC Health Serv Res, 2023, 23(1): 934.
20. Farmer J, Bigby C, Davis H, et al. The state of health services partnering with consumers: evidence from an online survey of Australian health services. BMC Health Serv Res, 2018, 18(1): 628.
21. 张育琳, 金晓凤, 黄文婷, 等. 改善患者就医体验提升满意度实践探索. 中国医院, 2024, 28(6): 88-90.
22. 张霄艳, 王静, 王雨璇. 武汉市基层医疗机构就诊患者的感知服务质量和满意度对忠诚度的影响机制分析. 医学与社会, 2023, 36(6): 59-63, 99.
23. 张蕊, 赵丽亭, 吴美, 等. 加速康复外科多学科团队协作模式在日间手术中应用的范围综述(英文). 中西医结合护理(中英文), 2023, 9(7): 180-185.
24. 王淼, 杨丽, 黄一敏, 等. 上海市级医院儿童日间手术进展与思考. 中国卫生质量管理, 2021, 28(3): 1-2, 8.

West China Medical Journal

Study on interactive journey map of perioperative medical experience of patients undergoing pulmonary nodule day surgery under enhanced recovery after surgery mode

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